揭示肿瘤反应性基质在胆管癌中的作用:新治疗策略的契机。
Unveiling the role of tumor reactive stroma in cholangiocarcinoma: an opportunity for new therapeutic strategies.
作者信息
Cadamuro Massimiliano, Morton Stuart Duncan, Strazzabosco Mario, Fabris Luca
机构信息
Department of Surgery, Oncology and Gastroenterology, University of Padova, Italy.
Section of Digestive Diseases, Yale University, New Haven, Connecticut, USA.
出版信息
Transl Gastrointest Cancer. 2013 Jul;2(3):130-144. doi: 10.3978/j.issn.2224-4778.2013.04.02.
Cholangiocarcinoma (CCA) is a very aggressive neoplasm, whose incidence has steadily increased in the last decade. Despite its growing epidemiological impact, therapeutic chances with a curative intent are still limited to surgical resection and, in highly selected cases, to liver transplantation. Unfortunately, in most cases at the time of diagnosis, CCA has already metastasized to regional lymph nodes, thereby reducing the opportunities for curative treatment. Mechanisms governing CCA invasiveness are unclear. A critical element of CCA is the abundant "tumor reactive stroma", which develops in close association with tumor growth. An abundant reactive stroma is present in a number of carcinomas characterized by strong invasiveness, namely gastric, colorectal and pancreatic cancers, as well as breast cancer. In tumor stroma, a variety of signals and mediators are reciprocally exchanged between stromal and cancer cells that, in turn acquire pro-invasive properties. These paracrine communications have started to be elucidated only recently, and may represent targets amenable of specific therapeutic intervention. In this review, we will highlight the cell types that compose the tumor reactive stroma in CCA and some of the molecular interactions possibly responsible for increased invasiveness of CCA. The possibility of dissecting, and likely exploiting, these interactions for potential new treatments will be also described.
胆管癌(CCA)是一种侵袭性很强的肿瘤,在过去十年中其发病率稳步上升。尽管其流行病学影响日益增大,但具有治愈意图的治疗机会仍然仅限于手术切除,在极少数特定病例中可进行肝移植。不幸的是,在大多数诊断时的病例中,CCA已经转移至区域淋巴结,从而减少了治愈性治疗的机会。目前尚不清楚CCA侵袭性的调控机制。CCA的一个关键要素是大量的“肿瘤反应性基质”,它与肿瘤生长密切相关。大量反应性基质存在于许多具有强侵袭性的癌症中,即胃癌、结直肠癌、胰腺癌以及乳腺癌。在肿瘤基质中,多种信号和介质在基质细胞与癌细胞之间相互交换,进而使癌细胞获得促侵袭特性。这些旁分泌通讯直到最近才开始得到阐明,并且可能代表了适合进行特定治疗干预的靶点。在这篇综述中,我们将重点介绍构成CCA肿瘤反应性基质的细胞类型以及一些可能导致CCA侵袭性增加的分子相互作用。还将描述剖析并可能利用这些相互作用进行潜在新治疗的可能性。